心脏移植患者围术期的集束化护理干预策略分析

Analysis of interventional strategies of cluster nursing in patients undergoing heart transplantation

目的探讨心脏移植患者集束化护理方案及其效果评价。方法选择2015年6月-2017年12月武汉大学人民医院心血管外科收治的25例心脏移植患者为对照组,选择2018年1月-2019年4月本院心血管外科收治的38例心脏移植患者为观察组。对照组采用心脏移植常规护理方法,观察组采用基于循证的集束化护理方案,比较两组患者术后机械通气时间、重症监护时间、住院时间、感染发生率,分析集束化护理对心脏移植患者的应用效果。结果与对照组相比,观察组术后机械通气时间[(7.53±2.75) h比(14.92±12.44) h]、重症监护时间[(4.26±1.71)d比(6.21±1.19)d]及住院时间[(18.05±4.1)d比(20.79±7.03)d]均显著降低,差异具有统计学意义(P <0.01)。两组的感染发生率均为0%,数据比较无统计学意义。结论在心脏移植患者护理管理中,应用集束化护理干预策略,能缩短机械通气时间、重症监护时间及住院时间。

Objective To investigate the efficacy of clustering care program for heart transplant patients. Methods Twenty five heart transplant patients admitted to our hospital from June 2015 to December 2017 were enrolled as the control group, 38 heart transplant patients admitted to our hospital from January 2018 to April 2019 were selected for observation group. The control group received the routine nursing method of heart transplantation. The observation group received the evidence-based clustering nursing program to implement the heart transplantation bundled nursing training, the nurses mastered the bundled nursing program and implemented it accurately. The postoperative mechanical ventilation time, intensive care unit stay time, hospitalization time, infection rate and incidence of severe rejection were compared between the two groups. The effect of cluster nursing on heart transplantation patients was analyzed. Results Compare to the control group, there were significant differences on the postoperative mechanical ventilation time( 9.2±6.43)h vs.(14.92±12.44)h, the intensive care unit stay time(4.26±1.71)d vs.(6.21±1.19)d and the hospitalization time(18.05±4.1)d vs.(20.79±7.03)d, respectively(P < 0.01). While there were no differences in the incidence of infection and the incidence of severe rejection of the two groups. Conclusion For the nursing management of heart transplant patients, the application of clustered nursing intervention strategy can shorten the time of mechanical ventilation, intensive care unit stay time and hospitalization time.